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INTERMITTENT FEVER.

[Read before the Wayne County (N. Y.) Homoeopathic Medical Society. December 5th, 1865.]

By AD. Lippe, M. D., Philadelphia, PA.

Cullen's assertion that bark cured all cases of intermittent fever, because it was both bitter and aromatic, first gave to Hahnemann the occasion to expose the errors of the then great authority in medicine, who in years was greatly his senior. Hahnemann knew that Cinchona cured but a comparatively small number of cases of intermittent fever; he also knew that other substance, both bitter and aromatic, never cured a case of this disease. Hahnemann was compelled to institute a new mode of investigation, and first he endeavored to ascertain with certainty what cases of intermittent fever were curable by Cinchona. For this purpose he proved Cinchona first on himself, afterwards on others, and by this new plan of investigation, by these provings, he was enabled to give us the characteristic symptoms of Cinchona, which indicated it in the cure of intermittent fever. From this, Hahnemann's first investigation, were developed the fundamental principles of our school, named and termed by its discoverer.

The question Hahnemann first asked himself was: “What are the peculiarities, the characteristics of intermittent fever curable by Cinchona?” We ask this question in our own days: What is the remedy, how shall we treat intermittent fever, or how can we find the homoeopathic remedy for each individual case? If we follow Hahnemann's advice, we will be able readily to solve these questions. Many remedies have been proved and their characteristic symptoms defined. Among them are some of our native plants as Eupatorium perfoliatum, Gelsemium, etc.

The fact that Homoeopathy was developed by investigating the relation in which Cinchona stood in regard to intermittent fever, leaves no room for doubt that there exists the curative remedy for each individual case of intermittent fever. This will be admitted to be, theoretically, correct - but not practically. It is asserted that some cases will not yield to any homoeopathic remedy and some physicians even say that in certain seasons and in some localities we must resort to large doses of Cinchona. When Hahnemann, by strictly logical argument, demonstrated the error of Cullen's assertion, and when he afterwards proved his argument by practical experiment, and gave to the world the law of cure and the practical rules to guide us; the practice based on these principles and rules has always been proved correct. There can reasonably be no exception to these well-established principles and rules, neither season nor locality nor individuality can offer cause for an exception.

The facts are found to be:

1. Some cases of intermittent fever are cured by certain persons, in certain localities, by homoeopathically selected and potentized medicines.

2. Other cases of intermittent fever are not cured by certain persons in certain localities by homoeopathically selected and potentized medicines.

If this is true we must see where the fault is. If under one the law of cure by the experiment is successful, in the hands of some persons, why is it the reverse under two?

The variety of possibilities for want of success under two are:

a. The law of cure, as we understand it, has been applied but without success. If this were the case, then the law of cure could not be correct or true, for the law, like all natural laws, must be true under all circumstances without regard to time or locality.

b. The law of cure, as we understand it, has not been applied and, therefore, there was no success. This may arise from two principle causes; first, the law of cure was not properly applied because not properly understood; or, secondly, the means to apply it (the medicines and their provings) were not known, nor understood by the prescribing physician. There may be a lack of qualification to examine the patient, that is, to obtain a picture or the disease or a lack of qualification to select the proper remedy.

If we should admit a, which we would if we asserted that time and locality annuls or supersedes the otherwise applicable law of cure, we would declare Homoeopathy, based on these laws, to be fallacious, incorrect and of no benefit to the sick. But the law holding good in every other case of disease, at all times and in all localities, this assertion must be set aside, cannot be held or defended.

The failure to cure intermittent fever with homeopathically chosen remedies and potentized medicines must rest with the practitioner, who either does not understand or cannot properly apply the homoeopathic law.

To those unfortunate men, who call themselves Homoeopathicians but reject Hahnemann's teachings, we have nothing to say; they must be and will remain unsuccessful, not only in the treatment of intermittent fever, but also of all other diseases. We address ourselves to those Homoeopathicians, who knowing the laws of cure seek to find the means and mode of applying them successfully for the cure of intermittent fever, in such cases, in which at times they had failed to effect a cure. This want of success may be,

1st. That we have not properly examined the case,

2d. We may not have found the truly curative remedy; or,

3d. We may not have applied it properly.

We will take up these cases seriatim.

1st. In examining a case of intermittent fever, we may find characteristic symptoms for one of the known remedies or we may not; if we do not find any, it may be because we do not know them, and this is essentially our own fault; Or,

2d. If the characteristic symptoms are not marked, we select the remedy by other means - analogy. Again, there may be no characteristic symptoms, as in cases where there is simply a chill followed by fever and perspiration, and no strongly marked concomitant symptoms. In this case we must look to the symptoms of the patient during the apyrexia and to his constitutional symptoms — these will often assist us in finding the proper remedy.

3d. We may have been too hasty in repeating or changing the remedies. We should have obeyed the master's advice, and allowed each remedy to exhaust its action before repeating or changing it.

But how to find the truly curative remedy in a case of intermittent fever is after all the vexed question. Dr. von Boenninghausen in his essay on “Intermittent Fever” has almost exhausted the question, but we cannot too often refresh our memory.

1st. The examination of the patient as to the time and Periodicity - the various stage of paroxysm - the concomitant symptoms of each stage and the symptoms predominating during the apyrexia.

2d. The selection of the remedy. The truly curative remedy may be indicated by the time and periodicity, as under Natrum mur., ten, p.m., Lycopodium, four, p.m., Nux vom., in the morning, Apis when in the afternoon, and also Lachesis, Cactus grand., Nitric acid, etc., at the same hour every day Sabadilla, Aranea, etc. Again by the concomitant symptoms, as thirstlessness under Pulsatilla, China, Sabadilla. Thirst before the chill, Eupatorium, Arsenic, China, Pulsatilla; or only during the chill, Capsicum, Carbo veg., etc.; or between the chill and fever, China, Sabadilla, etc. The thirst during the fever paroxysm may be for large quantities of cold water at a time as under Bryonia, or for small quantities at a time as under Arsenic, Lycopodium, etc., or the paroxysm is accompanied by headache as under Natrum mur., which under Arsenic continues after the paroxysm, or the fever is accompanied by sleep as under Apis, Gelsemium, Cactus grand., etc. We must refer to Dr. von Boenninghausen's excellent essay on “Intermittent Fever” for more minutiae.

3d. The remedy properly chosen should be administered very soon after the paroxysm is over and only during the apyrexia, never during the paroxysm. If the next paroxysm is not changed in any way either as to time or in its concomitant symptoms, and if no new symptoms belonging to the remedy have been developed, our choice of the remedy may be supposed to have been faulty. If the paroxysm changes as to time and the next attack comes on earlier, we may reasonably expect an improvement and should not repeat the remedy; if the next attack is accompanied by symptoms characteristic of the remedy, or if the attack is lighter we should not repeat the remedy, if the attacks continue but are lighter each time, we may safely wait on the effects of the medicine given. If the attacks continue and the symptoms having guided us in the selection of the remedy cease, then we must choose another remedy. We must follow implicitly Hahnemann's rule - not to repeat the dose or give a new remedy until the effect of the former dose is exhausted.

The more carefully we apply the law of cure to the treatment of intermittent fever the more brilliant will be our success.